|
SOMNODENT EDENTULOUS CLASSIC
|
SOMNOMED INC
|
MAS RXA HARD ACRYLIC EDENTULOUS
|
E0486
|
09/22/2011
|
09/23/2012
|
|
|
SOMNODENT HERBST CLASSIC
|
SOMNOMED INC
|
HERBST CLASSIC
|
E0486
|
08/09/2013
|
|
|
|
ASA FH ORAL APPLIANCE
|
AMERICAN SLEEP ASSOCIATION
|
|
E0486
|
03/15/2013
|
02/17/2016
|
|
|
SOMNODENT HERBST ADVANCE FLEX
|
SOMNOMED INC
|
HERBST ADVANCE FLEX
|
E0486
|
09/22/2014
|
|
|
|
ORAVAN HERBST
|
ORAVANOSA LLC
|
ORAVAN HERBST
|
E0486
|
12/07/2015
|
|
|
|
RESPIRE PINK SERIES - HERBST +
|
RESPIRE MEDICAL
|
SPP000US
|
E0486
|
03/06/2017
|
|
|
|
ADJUSTABLE HERBST OASYS HINGE SLIMLINE (PRESSURE MOLDED)
|
SPACE MAINTAINERS LABORATORY
|
63250SLS
|
E0486
|
09/07/2018
|
|
|
|
ADJUSTABLE HERBST OASYS HINGE DUAL LAMINATE
|
SPACE MAINTAINERS LABORATORY
|
63250PS
|
E0486
|
09/07/2018
|
|
|
|
KAVA HERBST
|
SKETCHPAD INNOVATIONS LLC
|
|
E0486
|
08/30/2019
|
|
|
|
MEDLEY ROD SLEEVE
|
GREAT LAKES DENTAL TECHNOLOGIES
|
|
E0486
|
05/29/2019
|
|
|
|
PANTHERA D-SAD CLASSIC
|
PANTHERA DENTAL INC
|
|
E0486
|
07/09/2022
|
|
|
|
FLEXTAP
|
AIRWAY MANAGEMENT INC
|
TAP-FLEX-100
|
E0486
|
11/18/2022
|
|
|
|
APNEARX PRO
|
APNEA SCIENCES CORPORATION
|
APP001
|
E0486
|
11/10/2022
|
|
|
|
RESPIRE CLEAR
|
RESPIRE MEDICAL
|
|
E0486
|
09/17/2022
|
|
|
|
TAP
|
AIRWAY MANAGEMENT INC
|
TAP
|
E0486
|
03/02/2011
|
09/27/2012
|
|
|
THE SUAD ELITE
|
STRONG DENTAL LTD
|
SUAD ELITE
|
E0486
|
11/07/2011
|
09/25/2012
|
|
|
ADJUSTABLE DORSAL APPLIANCE/ PMT BASE
|
SPACE MAINTAINERS LABORATORY
|
63225
|
E0486
|
01/25/2012
|
09/13/2012
|
|
|
ADJUSTABLE DORSAL APPLIANCE
|
SPACE MAINTAINERS LABORATORY
|
63225A
|
E0486
|
01/23/2012
|
09/13/2012
|
|
|
OASYS HINGE APPLIANCE NASAL DILATORS
|
DREAM SYSTEMS LLC
|
M002
|
E0486
|
07/02/2015
|
|
|
|
PROSOMNUS [PH] HERBST-STYLE APPLIANCE
|
PROSOMNUS SLEEP TECHNOLOGIES
|
PROSOMNUS [PH]
|
E0486
|
03/28/2019
|
|
|
|
ASD MEZZO ORAL APPLIANCE
|
AMERICAN SLEEP DENTISTRY
|
ASD-MOA
|
E0486
|
11/01/2018
|
|
|
|
RESPIRE PINK AT MICRO
|
RESPIRE MEDICAL
|
SPPM000US
|
E0486
|
11/18/2022
|
|
|
|
PROSOMNUS EVO [PH] SLEEP AND SNORE DEVICE
|
PROSOMNUS SLEEP TECHNOLOGIES
|
PROSOMNUS EVO [PH]
|
E0486
|
12/06/2022
|
|
|
|
ADJUSTABLE PM POSITIONER
|
DENTAL SERVICES GROUP
|
|
E0486
|
09/14/2011
|
09/19/2012
|
|
|
SOMNODENT EDENTULOUS FLEX
|
SOMNOMED INC
|
MAS RXA SOFT FLEX EDENTULOUS
|
E0486
|
09/22/2011
|
09/23/2012
|
|
|
SOMNODENT FLEX
|
SOMNOMED INC
|
MAS RXA SOFT FLEX
|
E0486
|
09/22/2011
|
09/23/2012
|
|
|
KLEARWAY APPLIANCE
|
GREAT LAKES ORTHODONTICS LTD
|
W 101
|
E0486
|
09/22/2011
|
09/20/2012
|
|
|
HERBST ADJUSTABLE
|
DYNAFLEX
|
0056G
|
E0486
|
10/31/2012
|
|
|
|
TELESCOPIC HERBST SLEEP APPLIANCE
|
GREAT LAKES ORTHODONTICS LTD
|
I 102
|
E0486
|
12/21/2012
|
|
|
|
THE METZ APPLIANCE
|
THE METZ DENTAL LABORATORY INC
|
|
E0486
|
08/01/2014
|
|
|
|
ASA FH ORAL APPLIANCE
|
AMERICAN SLEEP DENTISTRY
|
|
E0486
|
02/18/2016
|
|
|
|
THE RESPIRE PINK SERIES - (MICRO)
|
RESPIRE MEDICAL
|
SM000US
|
E0486
|
05/04/2016
|
|
|
|
RESPIRE PINK SERIES - HERBST EF +
|
RESPIRE MEDICAL
|
SPP030US
|
E0486
|
03/06/2017
|
|
|
|
ADJUSTABLE HERBST OASYS HINGE ACRYLIC
|
SPACE MAINTAINERS LABORATORY
|
63250AS
|
E0486
|
09/07/2018
|
|
|
|
RESPIRE PINK SERIES-MICRO
|
MICRODENTAL LABORATORIES
|
SM000US
|
E0486
|
06/07/2019
|
|
|
|
SOMNODENT CLASSIC
|
SOMNOMED INC
|
MAS RXA HARD ACRYLIC
|
E0486
|
09/22/2011
|
09/23/2012
|
|
|
DORSAL APPLIANCE THERMAL
|
DYNAFLEX
|
# 0110T
|
E0486
|
09/30/2011
|
09/20/2012
|
|
|
TRUE FUNCTION ADJUSTABLE HERBST DUAL LAMINATE APPLIANCE
|
TRUE FUNCTION LABORATORY INC
|
(TFDL) DUAL LAMINATE
|
E0486 OR
A9270
|
04/26/2018
|
|
USE E0486 WHEN APPLIANCE IS MADE FROM A PHYSICAL POSITIVE MODEL. USE A9270 WHEN MADE FROM A DIGITAL MODEL.
|
|
TRUE FUNCTION ADJUSTABLE HERBST ACRYLIC WITH CLASP APPLIANCE
|
TRUE FUNCTION LABORATORY INC
|
(TFWC) ACRYLIC WITH CLASP
|
E0486 OR
A9270
|
04/26/2018
|
|
USE E0486 WHEN APPLIANCE IS MADE FROM A PHYSICAL POSITIVE MODEL. USE A9270 WHEN MADE FROM A DIGITAL MODEL.
|
|
ADJUSTABLE HERBST TURNBUCKLE DUAL LAMINATE
|
SPACE MAINTAINERS LABORATORY
|
63250TPS
|
E0486
|
09/07/2018
|
|
|
|
ASD ANTERIOR ORAL APPLIANCE
|
AMERICAN SLEEP DENTISTRY
|
ASD-AOA
|
E0486
|
03/22/2018
|
|
|
|
RESPIRE PINK SERIES - HERBST EF
|
MICRODENTAL LABORATORIES
|
SE000US-0
|
E0486
|
06/07/2019
|
|
|
|
RESPIRE PINK EF AT
|
RESPIRE MEDICAL
|
SPAT030US
|
E0486
|
11/04/2020
|
|
|
|
VIVOS MMRNA APPLIANCE
|
VIVOS THERAPEUTICS INC
|
|
E0486
|
10/23/2021
|
|
|
|
TELESCOPIC HERBST SLEEP APPLIANCE
|
GREAT LAKES DENTAL TECHNOLOGIES
|
INIST
|
E0486
|
06/22/2022
|
|
|
|
TELESCOPIC HERBST SLEEP APPLIANCE
|
GREAT LAKES DENTAL TECHNOLOGIES
|
IISTS
|
E0486
|
06/22/2022
|
|
|
|
SILENT NITE SLEEP APPLIANCE WITH GLIDEWELL HINGE
|
PRISMATIK DENTALCRAFT INC
|
|
E0486
|
10/06/2021
|
|
|
|
DORSAL APPLIANCE
|
DYNAFLEX
|
# 0110B
|
E0486
|
09/30/2011
|
09/20/2012
|
|
|
THE SUAD DEVICE
|
STRONG DENTAL LTD
|
SUAD DEVICE
|
E0486
|
11/07/2011
|
09/25/2012
|
|
|
THE SUAD DEVICE
|
STRONG DENTAL LTD
|
SUAD DEVICE
|
E0486
|
12/12/2012
|
|
|
|
THE SUAD ELITE
|
STRONG DENTAL LTD
|
SUAD ELITE
|
E0486
|
12/12/2012
|
|
|
|
RESPIRE PINK SERIES - HERBST
|
RESPIRE MEDICAL
|
RP01
|
E0486
|
11/27/2013
|
|
|
|
TAP 3 ORAL APPLIANCE
|
AIRWAY MANAGEMENT INC
|
TAP-3100-100
|
E0486
|
08/11/2014
|
|
|
|
SOMNODENT HERBST ADVANCE CLASSIC
|
SOMNOMED INC
|
HERBST ADVANCE CLASSIC
|
E0486
|
09/22/2014
|
|
|
|
DREAMTAP THERMACRYL
|
AIRWAY MANAGEMENT INC
|
TAP-DR75-THR
|
E0486
|
05/02/2016
|
|
|
|
RESPIRE PINK AT
|
RESPIRE MEDICAL
|
SPAT000US
|
E0486
|
04/14/2020
|
|
|
|
HERBST SLEEP APPLIANCE
|
GREAT LAKES ORTHODONTICS LTD
|
I 102
|
E0486
|
12/27/2011
|
09/10/2012
|
|
|
RESPIRE BLUE SERIES
|
RESPIRE MEDICAL
|
RB001
|
E0486
|
11/07/2011
|
09/20/2012
|
|
|
TAP- 3
|
SPACE MAINTAINERS LABORATORY
|
63316
|
E0486
|
01/26/2012
|
09/13/2012
|
|
|
HERBST SLEEP APPLIANCE
|
GERGENS ORTHO LAB
|
I 102
|
E0486
|
09/19/2012
|
|
|
|
HERBST ORAL APPLIANCE
|
DREAM SYSTEMS LLC
|
MC1
|
E0486
|
01/11/2013
|
|
|
|
CRANE ACRYLIC HERBST APPLIANCE
|
CRANE DENTAL LABORATORY INC
|
140429
|
E0486
|
07/28/2015
|
|
|
|
SNOREHOOK SPLINT
|
BOYD RESEARCH INC
|
SHS-1
|
E0486
|
10/05/2015
|
|
|
|
OASYS HINGE APPLIANCE NASAL DILATOR/LINGUAL LIFTERS
|
DREAM SYSTEMS LLC
|
M003
|
E0486
|
07/02/2015
|
|
|
|
RESPIRE PINK SERIES - HERBST EF
|
RESPIRE MEDICAL
|
SE000US-0
|
E0486
|
11/06/2015
|
|
|
|
DREAMTAP ACRYLIC
|
AIRWAY MANAGEMENT INC
|
TAP-DR75-PMMA (ACRYLIC)
|
E0486
|
05/17/2017
|
|
|
|
DREAMTAP THERMOPLASTIC
|
AIRWAY MANAGEMENT INC
|
TAP-DR75-THRP (THERMOPLASTIC)
|
E0486
|
05/17/2017
|
|
|
|
ADJUSTABLE HERBST TURNBUCKLE SLIMLINE (PRESSURE MOLDED)
|
SPACE MAINTAINERS LABORATORY
|
63250TSLS
|
E0486
|
09/07/2018
|
|
|
|
SLEEPAPP ADV
|
COMFORT ACRYLICS INC
|
|
E0486
|
02/14/2019
|
|
|
|
HERBST ADVANCE ELITE
|
SOMNOMED INC
|
|
E0486
|
04/14/2020
|
|
|
|
EMERALD HERBST
|
EMERALD DENTAL LAB
|
|
E0486
|
09/19/2023
|
|
|
|
RESPIRE PINK AT
|
MODERN DENTAL LABORATORY USA
|
SPAT000US
|
E0486
|
11/18/2022
|
|
|
|
TAP
|
AIRWAY MANAGEMENT INC
|
TAP 3
|
E0486
|
03/02/2011
|
09/27/2012
|
|
|
TAP
|
AIRWAY MANAGEMENT INC
|
TAP 3 ELITE
|
E0486
|
10/05/2011
|
09/27/2012
|
|
|
UCLA MODIFIED HERBST
|
SPACE MAINTAINERS LABORATORY
|
63250
|
E0486
|
01/23/2012
|
|
REVERIFIED USING NEW LOCAL COVERAGE DETERMINATION(LCD) & POLICY ARTICLE 9/10/2012
|
|
TAP-TL
|
SPACE MAINTAINERS LABORATORY
|
63313
|
E0486
|
01/25/2012
|
09/13/2012
|
|
|
TAP 3 - ELITE
|
SPACE MAINTAINERS LABORATORY
|
63316E
|
E0486
|
01/25/2012
|
09/13/2012
|
|
|
DENTAL CRAFTERS IST SNORING APPLIANCE
|
DENTAL CRAFTERS INC
|
|
E0486
|
01/11/2013
|
|
|
|
TAP
|
AIRWAY MANAGEMENT INC
|
TAP
|
E0486
|
12/21/2012
|
|
|
|
SOMNODENT HERBST FLEX
|
SOMNOMED INC
|
HERBST FLEX
|
E0486
|
08/09/2013
|
|
|
|
RESPIRE PINK SERIES-HERBST EF
|
MODERN DENTAL LABORATORY USA
|
SE000US-0
|
E0486
|
06/07/2019
|
|
|
|
RESPIRE PINK SERIES-MICRO
|
MODERN DENTAL LABORATORY USA
|
SM000US
|
E0486
|
06/07/2019
|
|
|
|
RESPIRE PINK SERIES -HERBST
|
MICRODENTAL LABORATORIES
|
RP01
|
E0486
|
06/07/2019
|
|
|
|
SILENT NITE SLEEP APPLIANCE
|
PRISMATIK DENTALCRAFT INC
|
|
E0486
|
07/13/2023
|
|
|
|
DORSAL APPLIANCE DUAL LAMINATE
|
DYNAFLEX
|
# 0110D
|
E0486
|
09/30/2011
|
09/20/2012
|
|
|
TAP
|
AIRWAY MANAGEMENT INC
|
TAP 3 ELITE
|
E0486
|
12/26/2012
|
|
|
|
OASYS HINGE APPLIANCE
|
DREAM SYSTEMS LLC
|
M001
|
E0486
|
07/02/2015
|
|
|
|
DREAMTAP TL
|
AIRWAY MANAGEMENT INC
|
TAP-DR75-TL
|
E0486
|
05/02/2016
|
|
|
|
MEDLEY ROD SLEEVE
|
TMD TECHNOLOGIES INC
|
|
E0486
|
11/01/2016
|
|
|
|
TAP T
|
AIRWAY MANAGEMENT INC
|
|
E0486
|
01/18/2007
|
12/31/2008
|
|
|
TRUE FUNCTION ADJUSTABLE HERBST ACRYLIC WITHOUT CLASP APPLIANCE
|
TRUE FUNCTION LABORATORY INC
|
(TFNC) ACRYLIC WITHOUT CLASP
|
E0486 OR
A9270
|
04/26/2018
|
|
USE E0486 WHEN APPLIANCE IS MADE FROM A PHYSICAL POSITIVE MODEL. USE A9270 WHEN MADE FROM A DIGITAL MODEL.
|
|
ADJUSTABLE HERBST TURNBUCKLE ACRYLIC
|
SPACE MAINTAINERS LABORATORY
|
63250TAS
|
E0486
|
09/07/2018
|
|
|
|
RESPIRE PINK SERIES-HERBST
|
MODERN DENTAL LABORATORY USA
|
RP01
|
E0486
|
06/07/2019
|
|
|
|
ASD LATERAL MEZZO ORAL APPLIANCE
|
AMERICAN SLEEP DENTISTRY
|
ASD-LMOA
|
E0486
|
11/01/2018
|
|
|
|
TELESCOPIC HERBST SLEEP APPLIANCE
|
GREAT LAKES DENTAL TECHNOLOGIES
|
IISTR
|
E0486
|
06/22/2022
|
|
|
|
TELESCOPIC HERBST SLEEP APPLIANCE
|
GREAT LAKES DENTAL TECHNOLOGIES
|
IIST
|
E0486
|
06/22/2022
|
|
|
|
RESPIRE PINK AT
|
MICRODENTAL LABORATORIES
|
SPAT000US
|
E0486
|
12/15/2022
|
|
|